title: Second malignancies in long-term testicular cancer survivors.
abstract: OBJECTIVE
  The objective of the present study is to analyze long-term testicular cancer (TC) survivors focusing on the correlation of therapeutic modalities used, the age of patients and second malignancy (SM) occurrence.
  
  
  METHODS
  A total of 1,367 patients with TC and different subsequent therapeutic procedures were followed up between 1970 and 2012. The occurrence of SM was analyzed by standard incidence ratios (SIR). SM occurred in 96 (7.0 %) patients with primary TC.
  
  
  RESULTS
  The most frequent SM was TC (SIR 27.4, n = 64); a significantly higher occurrence was observed after primary testicular seminoma. Prostate cancer appeared in 10 patients (SIR 5.2), with a mean age 54.9 years, while the typical age of patients in Slovakia was 71.4 years. Kidney cancer developed in 6 patients, a significant higher SIR was registered only after primary non-seminomas. The mean patient's age was 48.5 years, while the typical age of all male patients in Slovakia was 62.4 years. Other SM had no significantly higher SIR. Colorectal cancer appeared in 8 patients with primary TC, with a mean age 56.0 years, while the typical age of male patients with primary colorectal cancer in Slovakia was 67.1 years. Other non-testicular tumors appeared in 8 patients. SM occurs in 1.5 % of patients following orchiectomy alone, in 4.3 % following radiotherapy, 5.0 % following chemotherapy and in 4.4 % following combined chemo-radiotherapy.
  
  
  CONCLUSIONS
  Preliminary analyses indicate increased SM occurrence in patients with primary TC in comparison with the general population, and it also occurs in younger age at the time of SM diagnosis.
authors.affiliation: 1st Department of Oncology, Faculty of Medicine, St. Elisabeth Cancer Institute, Comenius University, Heydukova 10, 812 50, Bratislava, Slovak Republic, dalibor.ondrus@ousa.sk.
authors.forename: D
authors.initials: D
authors.lastname: Ondrus
authors.forename: M
authors.initials: M
authors.lastname: Ondrusova
authors.forename: L
authors.initials: L
authors.lastname: Friedova
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology* / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D018239:Seminoma / Q000453:epidemiology* / Q000628:therapy; D018154:Slovakia / Q000453:epidemiology; D017741:Survivors; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors; D055815:Young Adult